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Hand, Foot, and Mouth Disease

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What is hand, foot, and mouth disease?


Hand, foot, and mouth disease (HFMD) is a common viral infection in infants and children that is caused by enteroviruses (most often Coxsackievirus A16).  Symptoms begin 3-7 days after exposure and usually begin with a fever, poor appetite, a general feeling of being sick, and a sore throat. One to two days later, persons usually develop painful sores in the mouth and a rash with blisters. The rash does not itch and is usually located on the palms of the hands and soles of the feet, but may also be on the buttocks.


How do you get hand, foot, and mouth disease?


 HFMD is spread by direct contact with nose and throat discharges (coughing, sneezing), saliva, fluid from blisters, and stool of infected persons. Persons are very contagious in the first week of illness, but virus can be shed in the stool for several weeks.




How serious is hand, foot, and mouth disease?


Most persons experience a mild illness and recover without medical treatment in 7 to 10 days. The most common complication is dehydration because the mouth sores can make swallowing difficult and painful. In rare cases, a serious form of the virus may cause viral meningitis or encephalitis, which can be life-threatening.



Who is at risk for hand, foot, and mouth disease?


HFMD occurs mainly in children under 10 years old, but may occur in adults as well. HFMD is most common in children in child care settings, where diaper changing and potty training are constant and little hands are often in and out of the mouth frequently. Everyone is at risk for infection, but not everyone who is infected gets ill. Children are more likely to experience illness because they may not have immunity from a previous infection. Infection results in immunity to the specific virus, but a second episode may occur resulting from a different type of enterovirus. HFMD is more common in the summer and early autumn months.


How can I prevent my child from hand, foot, and mouth disease?


  • Wash your hands often with soap and warm water, particularly after coughing or sneezing, diaper changes, using the bathroom, and before cooking and eating!


  • Clean contaminated surfaces and soiled items (including toys) with soap and water, and then disinfect with diluted bleach solution (mix ¼ cup bleach with 1 gallon of water).


  • Avoid close contact (kissing hugging, sharing utensils, etc.) with infected children.


  • Cover coughs and sneezes with a sleeve or tissue and dispose of tissues promptly.


What should I do if I think my child has hand, foot, and mouth disease?


Your healthcare provider can usually diagnose HFMD upon visual examination. No specific treatment is available, but symptomatic treatment can be given to relieve fever, aches, pain from the mouth sores, and to maintain hydration.


Should my child attend daycare if he or she has hand, foot, and mouth disease?


There are no specific recommendations for excluding children with HFMD from child care settings, although children with a fever should stay home. Excluding children may not prevent additional cases because the virus can be excreted for weeks after the symptoms have disappeared. Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands. Your child care provider may recommend that your child stay home if the child is unable to participate in activities or if the provider is unable to care for the child without compromising the ability to care for other children.


References and More information:


American Academy of Pediatrics: Managing Infectious Diseases in Child Care and Schools, A Quick Reference Guide, 2004.


Centers for Disease Control and Prevention:


Mayo Clinic:



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